Plantar Plate Injury
What is a Plantar Plate Injury?
A plantar plate injury will often present as pain underneath the ball of the foot usually under the second toe. This injury usually occurs due to excessive load or compression load occurring beneath the joint.
The exact cause is usually multifactorial. Improper footwear such as high-heeled shoes, foot structure, and the way you walk all likely contributing factors.
Plantar plate injuries can range from localised sensitivity to complete tears which can lead to further complications.
It is very important to treat this condition as early as possible. Without effective treatment a plantar plate injury can deteriorate to the point where surgery is required.
Symptoms
- Tenderness or sharp pain under the ball of the foot which may sometimes radiate into the toe (usually the second toe)
- Localised swelling underneath the ball of the foot
- Hammer toe contracture in severe cases (usually the second toe)
Treatment
Effective treatment involves offloading the area of pain in order to promote healing.
Offloading may include a one or a combination of the following:
- Strapping
- Padding
- Footwear
- Orthotic therapy
- Laser Therapy
Strapping and Padding
Strapping and padding can be very effective in the short to medium term.
Exmaples of effective strapping and padding include:
Plantar plate taping
Taping can be an effective, simple short term pain relief intervention.
Fix toe device
The Fixtoe device is an excellent alternative to traditional taping and padding. It is adjustable and can be worn in nearly any shoe.
Footwear
You should avoid high-heeled shoes and ill-supportive shoes that lack cushioning.
We sometimes recommend shoes that have a forefoot rocker sole. A forefoot rocker can be very effective at reducing pressure under the ball of the foot, making it potentially a good option for reducing forefoot pain.
In addition to a forefoot rocker sole, a stiffer soled shoe can also be helpful. A stiffer sole can help immobilise the ball of the foot through limiting the amount of flexion through the toe joints.
Some examples of shoes we may recommend:
HOKA Bondi
Brooks Addiction
In order to help determine what type of shoe is most suitable for you, we highly recommend making an appointment to have an assessment.
Foot Orthotic Therapy
Foot orthotic therapy can be a very effective solution when designed properly and used in conjunction with the correct shoe gear.
We typically recommend custom foot orthotic therapy for the management of a plantar plate injury as we can shape the orthotic more effectively to more evenly redistribute pressure.
However, where custom foot orthotic therapy is not practical or suitable, we have over-the-counter options that are less bulky and may potentially be more cost effective.
Laser Therapy
Depending on the severity, we may also suggest a course of laser therapy. Laser therapy in conjunction with a comprehensive management plan can be an excellent adjunct therapy that can further help with pain control, inflammation and improved recovery time.